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Weekly Chest CasesArchive of Old Cases

Case No : 1426 Date 2025-02-17

  • Courtesy of Jeong Joo Woo / Nowon-Eulji University Hospital
  • Age/Sex 44 / F
  • Chief ComplaintWorkup of proven breast cancer
  • Figure 1
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  • Figure 3
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  • Figure 5
  • Figure 6

Diagnosis With Brief Discussion

Diagnosis
Sclerosing pneumocytoma
Radiologic Findings
• A chest PA radiograph revealed a poorly defined nodule in the right middle lobe zone (RMLZ).
• Apart from the known right breast cancer, pre- and contrast-enhanced CT images showed a well-defined, approximately 15mm solid nodule in the right middle lobe (RML). The nodule exhibited moderate enhancement with a subtle inhomogeneous pattern. A so-called “vessel overlying sign” was observed on sagittal image. No findings, such as an air-gap sign or ground-glass opacity halo, were associated with the nodule.
• On a PET-CT scan, performed after breast cancer surgery, the nodule demonstrated mild FDG uptake with an SUV of 1.4.
Brief Review
PSP is a tumor, mostly benign in nature, with a proven pulmonary epithelial origin. PSP affects most frequently women in Eastern countries.
On CT, it appears as a peripherally located, well circumscribed, homogenously enhancing lesion. A few nonspecific signs have been described in CT, including marginal pseudo-capsule sign, overlying vessel sign, air-gap sign and halo sign, but these signs are not universal, and hence preclude a diagnosis based on radiology alone.
Calcification is rare and cavitation does not occur. They are described to be hypo metabolic on FDG-PET, although not always. A magnetic resonance imaging (MRI) does not provide any additional information towards the diagnosis.
Please refer to
Case 142, Case 148, Case 168, Case 268, Case 1023, Case 1035, Case 1118, Case 1245, Case 1254,
References
1. Manini C, Vezzini S, Conte A et al. Revisiting Pulmonary Sclerosing Pneumocytoma.Clin. Pract. 2024, 14(4), 1440-
2. Shin SY, Kim MY, Oh SY, et al. Pulmonary sclerosing pneumocytoma of the lung: CT characteristics in a large series of a tertiary referral center. Medicine (Baltimore). 2015 Jan;94(4):e498.
3. Lim JH, Lee N, Choi DW, et al. Pulmonary sclerosing pneumocytoma mimicking lung cancer: Case report and review of the literature. Thorac Cancer. 2016 Jul;7(4):508-11.
Keywords

No. of Applicants : 57

▶ Correct Answer : 25/57,  43.9%
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Fukuoka university , Japan KEISUKE SATO
  • - Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
  • - University of Yamanashi , Japan TAKAAKI HASHIMOTO
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - Kyoto City Hospital , Japan YUSUKE UTSUNOMIYA
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - , Japan SHUNJIRO NOGUCHI
  • - Affilitated Hospital of Jining Medical college , China JIANG SHENG HUA
  • - The First Affiliated Hospital of Nanjing Medical University , China TENG ZHANG
  • - Secomedic Hospital , Japan FUMINORI MIYOSHI
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - University of Yamanashi , Japan HIROYUKI MORISAKA
  • - Matsunami General Hospital , Japan TARO TAKEDA
  • - , Korea (South) DONG-HO BANG
  • - Kantou Rousai Hospital , Japan KAORU SUMIDA
  • - Kyoto University , Japan SHO KOYASU
  • - , Japan YOSHIKI ISHII
  • - University of Yamanashi , Japan HIROAKI WATANABE
  • - , Japan YUMI MAEHARA
  • - medical scanning , Japan HIROAKI ARAKAWA
  • - Mie university , Japan SHIKO OKABE
▶ Correct Answer as Differential Diagnosis : 11/57,  19.3%
  • - Kyoto University , Japan AKIHIKO SAKATA
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Presbyterian Medical Center , Korea (South) HANLIM SONG
  • - Jiangsu province hospital , China WANGJIAN ZHA
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - University of Yamanashi , Japan KOJIRO ONOHARA
  • - Toyota Kosei Hospital , Japan YUKI HAYASHI
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Oita university , Japan AYUMI KAMEI
  • - Other , Korea (South) CHAEHUN LIM
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